Growing ranks of uninsured also affects those with coverage

April 22, 2007

LAFAYETTE, Ind. (AP) - The growing number of Indiana residents lacking health insurance poses problems not only for the state's uninsured but also for those who are covered, experts say. As the number of uninsured grows, those with insurance face higher premiums, delayed emergency care and eventually loss of job opportunities as employers relocate elsewhere, said David Roos, state director of Covering Kids and Families, which promotes participation in Medicaid programs. "What most families feel is the pain in the pocketbook when their rates go up every year. They don't realize why. It's because more people are losing insurance," Roos said. "This is a problem that not only affects individual families, but it really does affect the infrastructure of the entire state." Monday marks the start of Cover the Uninsured Week, a nationwide campaign sponsored by the Robert Wood Johnson Foundation, whose programs include Covering Kids and Families. Since 1994, the number of Indiana residents without health insurance has increased by 223,680, or about the population of Fort Wayne, the Journal & Courier of Lafayette reported Sunday. Those uninsured people include Heather Shepard of Lafayette. She earns too much to qualify for Medicaid, can't afford insurance on her own, and her employer doesn't provide it. Medicaid is the government health insurance plan for the needy. "If I wasn't working, then I would be covered," she said. An Emory University study showed an Indiana family with insurance in 2005 paid an additional $953 in premiums to cover the cost of care for the uninsured. That's because doctors and hospitals recoup their costs by raising rates for those who can pay. Also pushing up insurance costs are Medicaid reimbursement rates that haven't been raised in years, according to state Rep. Tim Brown, R-Crawfordsville, a physician and ranking member of the House Public Health Committee. "The state has, because of budgetary issues, not increased reimbursement (rates) to providers for almost 17 years. So when they don't get those increases, guess where that cost gets shifted to? To the people paying the bills," Brown said. As insurance premiums go up, businesses that provide health benefits pass costs on to customers or to employees, or drop benefits altogether. Indiana lawmakers currently are negotiating on legislation proposed by Gov. Mitch Daniels that would fund health care coverage for low-income Indiana residents by raising taxes on cigarettes. It's uncertain whether the measure will pass before the General Assembly recesses later this week. Julie Novak, an associate dean who heads Purdue University's School of Nursing, said demand is growing for low-cost services such as five clinics staffed by nursing graduate students who practice under the supervision of advanced-practice nursing faculty. The clinics accept patients of any income level and use a sliding-fee scale for services. "These people are making choices, because of a limited income, between buying medication and putting food on the table," Novak said.